We appreciate Frank Elgar's recent letter to the editor drawing attention to our study of disordered eating attitudes and behaviours in a large school-based sample of teenaged girls in Ontario.1 We agree that self-report screening measures should not be used to diagnose eating disorders, and we did not use them for this purpose in our study. In the presentation of our findings, we have not suggested that the percentage of girls who scored above the cut-off on a self-report measure, specifically the Eating Attitudes Test-26 (EAT-26),2 be equated with the prevalence estimate of a psychiatric disorder in our sample. Nor did we use our other self-report screening measures (i.e., the Eating Disorder Inventory3 or the Diagnostic Survey for Eating Disorders4) as diagnostic instruments.
As Elgar correctly notes, many girls who scored above cut-off on the EAT-26 in our sample would likely not meet the criteria for a clinical eating disorder, based on a diagnostic assessment.5 However, self-report screening instruments can provide valuable information regarding the presence of disturbed attitudes and behaviours that may put some young women at increased risk for the development of clinical eating disorders.6,7 The alarmingly high frequency of disordered attitudes about weight and food and of unhealthy weight loss behaviours (as reported in our sample) highlights the importance of routine screening and the need for primary and secondary preventive interventions.
Jennifer M. Jones Research Scientist Toronto General Hospital Research Institute University Health Network Toronto, Ont. Marion P. Olmsted Director Ambulatory Care for Eating Disorders Toronto General Hospital University Health Network Toronto, Ont. Gary Rodin Head, Behavioural Sciences and Health Research Division Toronto General Hospital University Health Network Toronto, Ont.